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Query: UMLS:C0085580 (essential hypertension)
 14,686 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The antihypertensive effect of clonidine hydrochloride delivered at a constant rate for seven days by transdermal disks was evaluated in seven patients with essential hypertension. Blood pressure values measured at the physician's office were not significantly decreased by one month of treatment with one (n = 2) or two (n = 5) once-weekly applied clonidine transdermal disks. In contrast, blood pressure values recorded during patients' customary daily activities by means of a portable blood pressure recorder were considerably reduced, from 159/97 +/- 2/2 to 136/76 +/- 7/5 mm Hg. Plasma drug concentration at the end of the fourth week averaged 1.22 +/- 0.24 ng/mL. Plasma renin, vasopressin, and epinephrine levels were not modified by clonidine, whereas plasma norepinephrine level was significantly reduced. Local skin erythema developed in three patients and dry mouth in six. These findings suggest that clonidine transdermal disks lower blood pressure in hypertensive patients, but produce local skin lesions and general side effects.
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PMID:Transdermal clonidine therapy in hypertensive patients. Effects on office and ambulatory recorded blood pressure values. 396 74

The antihypertensive drug, clonidine, was administered to 18 patients, 8 females and 10 males, with WHO grade I-II essential hypertension in two forms, either as sustained-release depot capsule of 250 micrograms once daily or as standard clonidine preparation, 150 micrograms twice daily. The two drug forms were administered for 2 months each, in a double-blind, crossover outpatient study. Both preparations were equally effective in reducing blood pressure. The depot form of clonidine was preferred by the patients because of fewer side effects, which included sedation and dry mouth. The antihypertensive effect of clonidine was unrelated to pretreatment plasma renin activity. Depot forms of clonidine appear to offer the advantages of once-daily dosing and fewer side effects than standard clonidine preparations.
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PMID:Comparison of sustained-release and standard preparations of clonidine in essential hypertension. 636 8

Clinical assessment of a novel antihypertensive drug combination was undertaken in a group of essential hypertensive patients (n = 20). The effects of several doses of clonidine and its association with prazosin on blood pressure (BP), systolic time intervals (STI), and electrocardiogram (ECG) were investigated. Clonidine monotherapy induced a good BP control at 60%. BP was controlled in those patients in which prazosin was combined with clonidine (87.7%). LVETc was reduced by 0.3, 0.6, and 0.9 mg clonidine daily (p less than 0.05). PEPc was increased by only 0.9 mg, and it was diminished after its combination with 20 mg prazosin daily (p less than 0.05). PEP/LVET index was significantly increased by a higher dose of clonidine (p less than 0.05). ECG intervals did not change with the exception of PR, which was prolonged by 0.9 mg clonidine daily (p less than 0.05). Dry mouth, sedation, constipation, and drowsiness were the main side effects observed during the investigation. These results suggest an alternative treatment of essential hypertension, with a novel clinical application of drugs such as clonidine and prazosin, which have pharmacologic action via different alpha-adrenergic mechanisms.
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PMID:Clonidine and prazosin in the treatment of hypertensive outpatients--a preliminary study. 664 91

The antihypertensive efficacy and side effects of a transdermal therapeutic system containing 2.5 mg clonidine (clonidine-TTS) was investigated in 21 patients with essential hypertension over a period of 10 weeks. The system was designed to release 0.1 mg clonidine/24 h. Mean systolic and diastolic blood pressure fell from 160 +/- 17/106 +/- 7 mm Hg to 139 +/- 16/91 +/- 8 mm Hg after 4 weeks and to 135 +/- 14/89 +/- 8 mm Hg after 10 weeks (p less than 0.001). Sufficient blood pressure control was achieved by one clonidine-TTS weekly in 24% and by 2 clonidine-TTS in 33% of the patients. 43% of all cases required additional oral therapy with 50 mg hydrochlorothiazide/day. However, antihypertensive action was accompanied by a high incidence of local skin reactions. These skin reactions with erythema, itching and red papules occurred in 6 of the 21 patients (29%) after treatment with TTS for at least 4 weeks. Patch testing with the various components of clonidine-TTS in 4 patients identified clonidine-allergy of delayed type in 3 cases. Typical clonidine side effects such as fatigue, dry mouth, constipation and sexual disturbances were moderate. It is concluded that clonidine-TTS has a good and continuous antihypertensive action. However, the high incidence of skin reactions limits its use in the treatment of essential hypertension.
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PMID:[Clonidine transdermal therapeutic system in essential hypertension: effect and tolerance]. 667 36

Estulic (guanfacine), a new centrally acting antihypertensive agent derived from guanidine, was administered to 13 patients with established essential hypertension. Therapeutic effect and safety were evaluated in all patients during the first year. Blood pressure normalization was elicited in 6 patients and a good therapeutic response in 5. Two patients did not respond to the monotherapy. Dryness of the mouth was observed in 11 patients during the first year and tiredness in 4. At the end of the first year, 3 patients out of 7 who completed the 1-year treatment still complained of dry mouth. Five patients continued for a second year of treatment. In all of them the blood pressure was normalized and only one patient suffered from dryness of the mouth. Estulic was usually given once daily in the evening; in some patients it was given twice daily. At the end of the first year, doses between 2 and 7 mg were used (mean 3.4 mg); during the second year 2 mg/day was administered to 2 patients, 3 mg/day to 2 patients and 5 mg to 1 patient. No impairment of laboratory values was seen during long-term treatment. In one patient with renal insufficiency the treatment had to be discontinued owing to deterioration of the underlying disease. After withdrawal of the drug, no rebound hypertension was observed.
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PMID:[Estulic in the long-term treatment of hypertension]. 678 68

The effects of oral guanfacine were examined in six patients with essential hypertension. Guanfacine caused a substantial fall in both lying and standing systolic and diastolic blood pressure. The fall in pressure was evident by 6 hr, maximal by 10 to 12 hr, and lasted as long as 36 hr. In four patients satisfactory blood pressure control throughout the day was achieved during inpatient administration with single daily doses of 2 to 4 mg in the evening. The other two patients required twice-daily dosing for optimal control of blood pressure. There was no evidence of tolerance to the hypotensive effect. Sedation and xerostomia were apparent after the first dose but did not limit dose titration. Guanfacine lowered lying and standing plasma norepinephrine; this continued on long-term dosing. Urinary catecholamines were reduced from 59.21 +/- 17.24 (mean +/- SEM) to 28.91 +/- 4.20 micrograms/24 hr after 7 days of treatment. The hemodynamic effects, side effects, and biochemical evidence of reduced sympathetic activity after guanfacine resembled the centrally acting antihypertensive clonidine, although guanfacine appeared to have a longer duration of action.
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PMID:Effects of single and multiple doses of guanfacine in essential hypertension. 700 28

Patients with mild to moderate essential hypertension were treated with guanabenz plus placebo (26 patients) or guanabenz plus hydrochlorothiazide (26 patients) for one year. Ambulatory plasma renin activity was determined during placebo treatment, after four weeks and one year of treatment with the study drugs, and one month after discontinuation of guanabenz while continuing the same hydrochlorothiazide dosage. Treatment with guanabenz plus hydrochlorothiazide proved more satisfactory than treatment with guanabenz plus placebo in that fewer patients were treatment failures, a smaller dosage of guanabenz was required, better control of supine blood pressure was achieved, and no increase in guanabenz dosage was needed to maintain chronic blood pressure control. Drowsiness, dry mouth, and dizziness were the side effects noted most commonly. Plasma renin activity was not significantly suppressed by chronic guanabenz therapy. Thus, guanabenz is an effective new antihypertensive that provides optimal blood pressure control when used with a diuretic.
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PMID:Effect of guanabenz and hydrochlorothiazide on blood pressure and plasma renin activity. 701 28

The efficacy, safety, and tolerability of lofexidine, a centrally acting imidazoline derivative, were compared to that of clonidine in a randomized double-blind trial in 28 patients with moderate essential hypertension. The study consisted of a washout phase, a placebo phase, a drug titration phase (0.2 to 1.6 mg/day, with hydrochlorothiazide added at 0.4 mg daily for supine and erect diastolic blood pressure above 90 mm Hg), and a maintenance phase lasting 3 mo. During the titration phase supine systolic and diastolic pressures fell in lofexidine patients from 143 +/- 4/98 +/- 3 to 122 +/- 3/81 +/- 2 mm Hg and in clonidine patients from 154 +/- 6/101 +/- 2 to 124 +/- 4/81 +/- 2 mm Hg (P less than 0.01), and erect systolic and diastolic pressures fell in lofexidine patients from 143 +/- 3/105 +/- 2 to 116 +/- 3/85 +/- 2 mm Hg and in clonidine patients from 156 +/- 6/104 +/- 2 to 117 +/- 4/82 +/- 2 mm Hg (P less than 0.01). Maximal doses of lofexidine and clonidine in combination with hydrochlorothiazide had equivalent antihypertensive effects, but when the effects of lofexidine and clonidine were compared at each dose level, larger doses of lofexidine patients in either the supine or erect position during the titration phase but heart rate fell in the clonidine patients (P less than 0.05) over the same period. Dry mouth and drowsiness were reported in both groups but were both less frequent and less severe in the lofexidine group than the clonidine group.
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PMID:Lofexidine and clonidine in moderate essential hypertension. 703 May 78

The results of a double-blind cross-over study designed to evaluate the antihypertensive efficacy and safety of guanabenz versus methyldopa in mild-to-moderate essential hypertension are presented. Thirty patients were randomly assigned to a group receiving either guanabenz or methyldopa as initial therapy for 8 weeks, followed by a 2-week wash-out period; the patients then took the other trial medication for 8 weeks. There was a significant fall in both standing and supine systolic and diastolic blood pressures during each treatment period, but no statistically significant difference between the guanabenz and methyldopa periods. However, there was a significant difference between the two drugs as regards side-effects. In the guanabenz group 21% of patients stopped taking the drug because of side-effects or inefficacy compared with none of the patients in the methyldopa group. The overall incidence of adverse experiences was 76% for guanabenz and 50% for methyldopa. There was a statistically significantly greater incidence of dry mouth with guanabenz then with methyldopa, while drowsiness was common in both groups. It is concluded that guanabenz is as effective as methyldopa in the therapy of mild-to-moderate essential hypertension but that the side-effects, particularly dry mouth, will seriously limit its usefulness.
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PMID:Guanabenz versus methyldopa in the therapy of mild-to-moderate hypertension. 705 65

Lofexidine, a new centrally acting antihypertensive agent, was compared in a double-blind study with clonidine in the treatment of mild (standing diastolic blood pressure 95-104 mm Hg) or moderate (105-129 mm Hg) essential hypertension. In dialy dosages of 0.2 or 0.4 mg, monotherapy with lofexidine produced significant decreases in blood pressure and heart rate that were not different from those with clonidine. Blood pressure and heart rate were not different from those with clonidine. Blood pressure control (supine and standing diastolic pressure less than 90 mm Hg) occurred in seven of eight mild hypertensives treated with lofexidine and in seven of ten treated with clonidine. In moderate hypertension, three of 11 and seven of ten, ten of the 14 responders to clonidine required dosages of 0.4 mg daily or less. The maximum dosage tested was 1.6 mg daily. Concomitant hydrochlorothiazide therapy was given to eight of the lofexidine responders and 12 of the clonidine responders. For both drugs, drowsiness and dry mouth were the chief complaints. Neither agent changed standard clinical biochemistries except for decreased potassium and increased bicarbonate concentrations due to concurrent diuretic therapy. Lofexidine to have clinical characteristics similar to those of clonidine. Each of these agents is best used in lower doses, which are frequently effective and less likely to produce symptomatic complaints.
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PMID:Centrally acting antihypertensive agents: a comparison of lofexidine with clonidine. 722 19


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